In this issue

Manipulating complexity in learning

This paper by Grierson et al. integrates the specificity of practise perspective with challenge point accounts of learning to show how reducing the difficulty of practise can improve the generalisability of skills acquired by novices. The authors present a learning experiment in which the retention and transfer performances of novices who acquired laparoscopic skills using a gaze-up endoscopic display were compared against those of novices who had practised on a gaze-down arrangement. The comparison reveals that the gaze-down arrangement (i.e. the simplified practise context) benefited learners. The data point to the importance that the manipulation of task complexity may have for optimising training programmes.

Grierson LEM, Lyons JL, Dubrowski A. Gaze-down endoscopic practise leads to better novice performance on gaze-up displays. Med Educ; 47: 166–72.

Interpersonal skills assessment via situational judgment tests

Although medical school curricula emphasise both academic and non-academic factors, formal medical school admission systems often assess only the academic aspects. In this study, Lievens proposes to formally measure interpersonal factors in large groups of students using situational judgement tests. Candidate scores on interpersonal video-based situational judgement tests at the time of admission to medical studies in Flanders were found to have significant added value over academic tests for predicting interpersonal grades and doctor performance. Therefore, assessing procedural knowledge about interpersonal behaviour is worthwhile. Interpersonal skills training during medical education does not negate the value of selecting students on those aspects at the time of admission.

Lievens F. Adjusting medical school admission: assessing interpersonal skills using situational judgement tests. Med Educ; 47: 182–9.

Social comparison influences students’ self-efficacy in a novel clinical rotation

The literature shows that students experience several difficulties in transitioning to novel clinical situations. Students may cope with these difficulties by comparing themselves with peer students who have already experienced that situation. In an experimental study, Raat et al. showed that this strategy of social comparison influences students’ estimates of their future performance. The effect depends on the comparison peer’s performance level and gender. This indicates that a peer student chosen for comparison will strengthen or diminish a student’s self-efficacy, which, in turn, may ease or hamper his or her learning. Social comparison theory is a rather new topic in the medical education literature and may prove helpful in elucidating student learning in transitions.

Raat AN(J), Kuks JBM, van Hell EA, Cohen-Schotanus J. Peer influence on students’ estimates of performance: social comparison in clinical rotations. Med Educ; 47: 190–7.

Adverse learning environments

Much has been written on the importance of the learning environment. Less has been written on features of positive learning environments. Almost nothing has been written on extremely adverse learning environments. How bad can an environment get before it has an effect? Wilkinson et al. report the effects of disruption on student assessment results in a city that had been affected by a series of earthquakes, including one that closed the medical school building for 2 years. Which earthquakes, of which size and at which times do you think might have the greatest impact?

Wilkinson TJ, Ali AN, Bell CJ, Carter FA, Frampton CM, McKenzie JM The impact of learning environment disruption on medical student performance. Med Educ; 47: 210–3.